Brain SPECT imaging and treatment with IVIg in acute post-infectious cerebellar ataxia: case report.

Abstract

A 19 year-old man presented with pharyngitis and cervical lymphadenopathy, followed by vomiting and acute cerebellar ataxia. Serologic studies were consistent with a recent Epstein-Barr virus infection. Although contrast-enhanced brain computed tomography and MRI scans were normal, brain perfusion single photon emission tomography (SPECT) examination using 99mTc-HMPAO, performed on the 15th day of illness, showed marked cerebellar hyperperfusion, suggesting a diagnosis of acute post-infectious cerebellitis. After treatment with intravenous human immunoglobulin (IVIg, 2 g kg-1 over three days), progressive neurologic improvement occurred over two weeks. A brain SPECT study repeated after two additional weeks demonstrated a normal perfusion pattern. We conclude that brain perfusion SPECT examination is useful in identifying post-infectious cerebellitis and in monitoring its clinical course. In addition, IVIg may be helpful in treating this condition.

• Authors: Y Daaboul, B A Vern, M J Blend
• Journal: Neurological research (Neurol Res) Vol. 20 Issue 1 Pg. 85-8 (Jan 1998) ISSN: 0161-6412 [Print] England
• PMID: 9471108 (Publication Type: Case Reports, Journal Article)

Chemical References

• Immunoglobulins, Intravenous
• Technetium Tc 99m Exametazime

Topics

• Adult
• Cerebellar Ataxia (diagnostic imaging, etiology, therapy)
• Cerebrovascular Circulation
• Encephalitis, Viral (complications)
• Herpesvirus 4, Human
• Humans
• Immunoglobulins, Intravenous
• Magnetic Resonance Imaging
• Male
• Technetium Tc 99m Exametazime
• Tomography, Emission-Computed, Single-Photon